This invention relates to a glove, a device for holding a glove, an apparatus for donning a glove comprising the combination of the glove holding device and a glove and a method of donning a glove using the apparatus. The invention is particularly concerned, though not exclusively, with the use of the apparatus with a sterile glove to allow the glove to be put on easily whilst maintaining the sterility of the glove. The invention is equally applicable to the donning of non-sterile gloves.
Gloves, including surgical gloves, are worn in a variety of environments that demand sterility, for example, in medical, laboratory, food-preparation and manufacturing “clean room” environments. There are numerous situations in which it is important to maintain the sterility of a glove as it is being donned.
In the medical environment, gloves are worn to prevent the hands of medical professionals from contacting a patient's body during a physical examination or a surgical operation. Protective gloves, in general, are universally recognised as a major safeguard against the risk of inadvertent or accidental infection or cross contamination of patients, of the wearer of the gloves and of the medical environment.
For example, the use of a single sterile glove on the non-dominant hand may be used to feel over a vein during the performance of a venipuncture to prevent contamination of a patient's bloodstream.
In the manufacturing “clean room” environment, gloves are worn to prevent the hands of a technician from directly contacting items, such as wafers and other devices supporting highly sensitive electronic circuits. Wearing non-sterile gloves in such an environment may lead to contamination of such items, making them unsuitable for use.
It is of the utmost importance that gloves that are manufactured to be sterile are kept in a sterile condition during storage. Where gloves are initially sterile it is often highly desirable, and in some cases mandatory, that the sterility of the gloves be maintained during the donning process. Sterility of the glove can be adversely affected during the process in which the wearer puts on or dons the gloves. Accordingly, the putting on or donning process is a major point of contamination of the sterile gloves. During the donning process, the hands or other sources of contamination can contact and contaminate the sterile gloves by the inadvertent transfer of microbes or other contaminants to the sterile glove surfaces.
In the medical profession, the risk of undesirable contamination arising during the donning process is reduced by putting the glove on by using one of two generally accepted techniques for unassisted donning. These two techniques are open glove donning and closed glove donning.
The open glove donning technique now used for donning gloves, for example surgical gloves, requires that the sealed package containing the sterile gloves be carefully opened so that the inner surfaces of the package, and more particularly, the outside surfaces of the gloves contained therein, do not come in contact with any non-sterile surface. The gloves are usually packaged with their cuffs averted; that is, turned inside out and folded downwardly. To don the right glove, the wearer grasps the right glove on the fold of the averted cuff with the left hand and the right hand is inserted into the glove opening. Next, the left glove is picked up and held with the right hand by slipping the gloved fingers of that hand underneath the averted cuff while the left hand is inserted into the glove opening. To complete glove donning, the averted cuffs are carefully pulled over the distal ends of the garment's sleeves so that the entirety of the previously exposed surfaces of the averted cuffs are on the insides of the gloves and the outsides remain untouched by un-gloved hands.
In the closed glove donning technique, the gloves are handled through the fabric of the sleeve itself, for example a surgical gown sleeve. As such, the wearer's hand does not extend outside from the sleeve until the open end of the glove is actually pulled over the sleeve. The closed glove donning technique may best be conveyed by describing its current use in a surgical arena. This method assumes that the wearer is already wearing a sterile surgical gown. Accordingly, the wearer uses the left hand while keeping it within the sleeve of the gown to pick up the right glove by its averted cuff. In this manner, the glove itself is not directly touched since the left hand is shielded by the sleeve. With the right hand extended palm upward but retained within the sleeve, the left hand places the palm of the glove with fingers pointing towards the wearer against the retained palm of the right hand. The closest edge of the averted cuff is grasped by the right hand through the sleeve fabric. Next, the left hand pulls the un-grasped averted cuff edge over the right sleeve and hand. The left hand is gloved in the same manner using the gloved right hand to appropriately place the left glove and pull it over the left sleeve and hand.
Both glove donning methods entail difficulties. The open glove donning technique requires a high level of finger and hand dexterity. The closed glove donning technique suffers from finger and hand dexterity being hampered while one's fingers remain shielded by the sleeve. As would be expected by such complex procedures, they are susceptible to numerous accidental contamination possibilities, especially during times of distress and urgency. Thus, a better method is needed that enables the wearer to don gloves without using the open or closed methods but using a method which is quicker, easier, more controlled, simple to practice, preformed, sterile and which does not necessitate the help of an assistant. In addition, this method should be economically cost effective to implement and practice.
In dental care settings, where the dentist or dental assistant is obliged to work inside the mouth, post-treatment infections occur because of poor hygiene practice. For example, dental office surveys by means of hidden video cameras revealed that sampled dentists wash their hands before donning gloves in only 23% of patient contacts and changed gloves between patients in only 56% of contacts (Porter et al. British Medical Journal 1996; 312: 705). By providing an improved method of donning sterile gloves which is quicker, easier and more efficient than existing methods, dentists and dental assistants are more likely to change gloves between patient contacts and the likelihood of the gloves becoming contaminated during the donning process is reduced. This would have the effect of reducing post-treatment infections.
The magnitude of the un-sterile glove problem comes into focus when one considers:
1. Apart from designated surgical operating rooms, un-sterile examination gloves are currently estimated at being used at the rate of more than 10 billion/yr. in U.S. health care facilities.
2. Studies by trained observers in sampled intensive care units and emergency rooms reveal that health care workers wash their hands before and after each patient contact only 20-40% of the time (Wurtz et al. Am. J. Infect. Control 1994; 22: 228-230; Nystrom. Infect. Control Hosp. Epidemiol. 1994; 15: 435-436; Meengs et al. J. Emerg. Nurs. 1994; 20: 183-188).3. A survey found that health care workers washed their hands before putting on examinations gloves, only 27 times out of a hundred (Thompson B. L. et al. Infect. Control Hosp. Epidemiol. 1997; 18: 97-103).4. The increased use of latex gloves by health care workers to protect themselves from HIV and HBV infections has led to a false sense of security among health care workers and patients and has lead to wide-spread failure to wash bands properly and adequately during patient care (Heptonstall & Mortimer. Lancet 1995; 345: 599-600).
The above examples demonstrate that there is high prevalence of failure to wash hands properly, if at all, between patient contacts amongst health care workers and dentists. Therefore, in these situations, the risk of contamination of a sterile glove coming into contact with an unwashed hand is far higher than if the hand had been thoroughly washed. An improved method of donning a sterile glove which minimises the risk of an unwashed hand coming into contact with the sterile outer surface of the glove would significantly reduce the chances of contamination. This, in turn, would reduce the chances of post operative infection, cross contamination, etc.
In the manufacturing “clean room” environment, an improved method of donning a sterile glove would also significantly reduce the chances of contamination. In this situation, contamination might be from grease, oil or other residues on the wearers hands which could severely affect any electronic circuits or other highly sensitive electronic equipment if such contaminants were to come into contact with the electronic circuits or equipment.
As can be seen, it is highly desirable to develop an apparatus and/or method which allows the donning of sterile gloves to be quicker, easier, more controlled, simpler to practice, preformed, sterile and which does not necessitate the help of an assistant. In addition, this apparatus and/or method should be economically cost effective to implement and practice.